Herpes Zoster (Shingles)

Herpes Zoster (shingles) is a recurrence of Varicella (chickenpox). Herpes Zoster has a much lower rate of transmission (is less contagious) than Varicella. It is transmitted by contact with the vesicle (blister) fluid of skin lesions, and in disseminated cases, by the respiratory route. Individuals with Herpes Zoster may be sources of infection for a week after the appearance of their skin lesions. Disseminated Herpes Zoster is contagious via the respiratory route during the first six days after the onset of the skin lesions (rash).

Symptoms

Rash with vesicles, pain (may be severe), paresthesias. The skin lesions may be local (unilateral and affect two or fewer dermatomes), or disseminated (bilateral or affect more than two dermatomes).

Plan

Unless the employee developed his/her case of chickenpox (in the past) at work, Herpes Zoster is not occupational. The employee will be treated by his/her personal physician.

Work status

If the employee has Herpes Zoster with a local rash he/she may work if the lesions are covered by a dressing and/or clothing. He/she must avoid caring for immune-compromised, pregnant, and pediatric/infant patients. If skin lesions are present on the face or head, the employee is not to work until all of the lesions are scabbed and crusted over. If the employee has disseminated Herpes Zoster, he/she is not to work for the first six days after the rash first appears. He/She will also need to be cleared to return to work by his/her personal physician and by Employee Health Services. If the employee reports to work with a rash that is either suspicious for Herpes Zoster or another infectious rash, he/she must be cleared by employee health or his/her personal physician to work. If employee health is closed, the employee is responsible for being evaluated and cleared by his/her personal physician prior to working.